title: Cytisine's potential to be used as a traditional healing method to help indigenous people stop smoking: a qualitative study with Māori.
abstract: BACKGROUND
  Māori experience a disproportionate amount of smoking-related harm (46% of adult Māori smoke). Effective cessation treatments that are both accessible and attractive to Māori are urgently needed. Cytisine (a plant extract found in Golden Rain [Cytisus laburnum L.] and the New Zealand Kowhai [Sophora tetraptera L.] has a similar molecular makeup to nicotine, has been used successfully as a cessation product in central and eastern Europe and central Asia for many years, and is low priced. Recent reviews have found that cytisine is twice as effective as a placebo for smoking cessation. This study aimed to explore cytisine's potential as a 'rongoā Māori' (traditional Māori remedy) and its attractiveness to Māori smokers compared with other cessation products.
  
  
  METHODS
  Māori that smoked were interviewed in two focus groups and eight individual semi-structured interviews. Two key informants were interviewed also.
  
  
  RESULTS
  Barriers to using cessation products were financial and effort cost, pervasive smoking among family and peers, environments permissive of smoking, and perceived cultural inappropriateness of treatments. Participants were very interested in cytisine, supported the idea that it would be acceptable to package it as a rongoā Māori, and all wanted to use it. Named appropriately, packaged and promoted as a Māori cessation product, participants thought cytisine would contribute to the restoration of Māori identity and traditional beliefs and practices in addition to reducing smoking.
  
  
  CONCLUSIONS
  Presented as a rongoā Māori, cytisine would likely be more attractive to Māori than currently available cessation products. Confirmation of efficacy and safety will be needed before promotion of the product could occur.
authors.affiliation: Centre for Tobacco Control Research, Social and Community Health, School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Te Pora
authors.initials: TP
authors.lastname: Thompson-Evans
authors.forename: Marewa P
authors.initials: MP
authors.lastname: Glover
authors.forename: Natalie
authors.initials: N
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000328:Adult; D000470:Alkaloids / Q000627:therapeutic use*; D001392:Azocines / Q000627:therapeutic use; D005260:Female; D006801:Humans; D031296:Laburnum / Q000737:chemistry; D008297:Male; D009520:New Zealand; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D010936:Plant Extracts / Q000627:therapeutic use; D011807:Quinolizines / Q000627:therapeutic use; D012907:Smoking / Q000208:ethnology* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D029909:Sophora / Q000737:chemistry; D055815:Young Adult; D000093843:Quinolizidine Alkaloids
chemical_list: D000470:Alkaloids; D001392:Azocines; D018722:Nicotinic Agonists; D010936:Plant Extracts; D011807:Quinolizines; C004712:cytisine; D000093843:Quinolizidine Alkaloids